Thesis submitted to the University of Manchester by Richard Macey for the Degree of Doctor of Philosophy entitled “Detection of Common Dental Diseases by Dental Hygiene-Therapists”, February 2016.Many adult patients that attend NHS dental practices on a regular basis are asymptomatic and do not need any further treatment other than a routine dental examination (“check-up”). As the oral health of the adult population is predicted to improve further, using the General Dental Practitioner to undertake the “check-up” on regular “low risk” patients represents a substantial and potentially unnecessary cost for state-funded systems. Given recent regulatory changes in the United Kingdom, it is now possible to delegate a range of tasks to Dental Hygiene-Therapists, including the routine clinical examination. This has the potential to release General Dental Practitioner’s time and increase the capacity to care at a practice level. The aim of this thesis was to determine the diagnostic test accuracy of Dental Hygiene-Therapists when detecting dental disease, explore the social acceptability of using Dental Hygiene-Therapists to manage “low risk” patients in practice and the feasibility of conducting a definitive trial. A mixed-methods approach was utilised with four inter-linked studies: 1. A diagnostic test accuracy study, which assessed the efficacy of Dental Hygiene-Therapists to detect dental caries and periodontal disease in a primary care setting (n=1899); 2. A comparative accuracy study, which investigated the ability of different dental professional groups to distinguish between photographs of malignant and non-malignant lesions (n=192); 3. A feasibility study, which examined the recruitment, retention and fidelity of using Dental Hygiene-Therapists to manage “low-risk” patients in practice over a twelve month period (n=60); and 4. A series of semi-structured interviews to determine the social acceptability of the use of Dental-Hygiene-Therapists in this role. A fifth study ran in parallel and involved undertaking a Cochrane Diagnostic Test Accuracy Systematic Review. This review informed the methods and conduct of the diagnostic test accuracy studies (studies 1 and 2). When compared to General Dental Practitioners (reference test) the Dental Hygiene-Therapists (index test) produced summary sensitivity and specificity points of 0.81 and 0.87 for dental caries, and 0.89 and 0.75 for periodontal disease respectively. When differentiating between malignant and non-malignant lesions, the Dental Hygiene-Therapist group were comparable to General Dental Practitioners for sensitivity (0.81 versus 0.77 respectively) and for specificity (0.73 versus 0.69 respectively). The feasibility results identified an acceptable recruitment rate of 34%, a retention rate of 63.33% and fidelity of 94.74%. The qualitative interviews found high social acceptability to the idea of using Dental Hygiene-Therapists to undertake routine dental examinations. These results suggest that Dental Hygiene-Therapists could be used to play a more substantial role in the management of “low risk” asymptomatic NHS patients in a primary dental care environment.

This work is focused on the fluctuating motivation of dental hygienists. The goal of this work is to find the causes which lead to these dental hygienists to leave this career path, their motivation and demotivation inside their workplace. The theoretical part begins with defining the dental hygienist and describes her work routine and duties. Following part will be devoted to the fluctuation and turnover rate in the workforce, the causes and consequences related to it. The third section of the theoretical part will concentrate on motivation; motivation as a concept, personal fulfilment and financial compensation as a motivation. The empirical part analyzes the motivation of the participating sample group used for this study. Qualitative research methods were used; semi-structured interviews were conducted and then analyzed. The practical output is a description of the motivators and dissatisfactions of the selected test group of dental hygienists. With the help of the interviews, the conclusion to the motivations was reached and recommendations were assembled for dentists, managers and business owners of establishments which use the services of dental hygienists. Key words: dental hygienist, motivation, turnover, job satisfaction.

No description available.

Psykosociala faktorer kännetecknar allt som inte berör fysiska omständigheter på en arbetsplats. En god psykosocial arbetsmiljö ses bland annat när det råder goda relationer med arbetskamrater och när ansvars- och beslutstagande möjliggörs. Eftersom det i dagsläget råder otillräcklig information inom området är syftet med denna studie att ta fram och utforma en enkät med frågor som berör tandhygienistens psykosociala arbetsmiljö. Frågorna i enkäten kommer att konstrueras utifrån de redan etablerade frågorna i Copenhagen Psychosocial Questionnaire, COPSOQ. Enkäten ska sedan prövas i en pilotstudie. Efter utförd pilotstudie redovisas respondenternas kommentarer på enkätens innehåll och disposition. Resultatet visar att frågorna i COPSOQ innehåller en del svagheter vad avser formulering och innebörd. För enkäten som helhet har både fördelar och nackdelar påträffats. Slutsatsen blir därför att enkäten inför eventuellt framtida ändamål bör bearbetas och förtydligas innan den realiseras. / Psychosocial factors characterize everything that does not concern physical circumstances at a workplace. A good psychosocial work environment is exemplified by good relations with colleagues and the possibility of taking responsibility and making decisions. The information regarding the dental hygienist psychosocial work environment is insufficient. The aim of this study is therefore to develop and design a questionnaire within the given subject. The questionnaire will be based on established questions in the Copenhagen Psychosocial Questionnaire, COPSOQ. The questionnaire will then be tested in a pilot study. The pilot study will present the respondents comments on the questionnaire, in terms of its content and presentation. Results show that the questions in COPSOQ contain some weaknesses regarding formulation and meaning. For the survey as a whole, both advantages and disadvantages were encountered. It is therefore concluded that the questionnaire for any future purpose should be reworked and refined before application.

<p>Syftet med studien var att jämföra den upplevda arbetssituationen hos tandhygienister inom folktandvården med tandhygienister inom den privata tandvården. Tandhygienister i södra Sverige som var registrerade hos SRAT (n=313) tillfrågades att delta i studien. Enkäten skickades ut elektroniskt, vilket gav en svarsfrekvens på 48% (n=151). Inom folktandvården svarade 59% (n=101) och inom den privata tandvården svarade 35% (n=50). Enkätfrågorna omfattade arbete, arbetsklimat, arbetssituation, profession, hälsa, inflytande och stöd i yrkesrollen samt bakgrundsfrågor om ålder, kön, anställningsform och arbetstid. Resultaten visade statistiskt signifikanta skillnader (p<0,05) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården gällande i vilken utsträckning de styrde över sina tidsbokningar, upplevde trötthet, orolighet, besvär från rygg, nacke eller axlar samt besvär från andra delar av kroppen. En statistisk signifikant skillnad (p<0,01) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården syntes även i vilken utsträckning respondenterna styrde över sin arbetstakt. Slutsatsen av studiens begränsade material är att tandhygienisterna inom den privata tandvården tycktes ha en mer positiv syn på deras arbetssituation än tandhygienisterna inom folktandvården.</p> / <p>The aim of this study was to compare the perceived work situation among dental hygienists in the public dental health service with dental hygienists in private practice. Dental hygienists in southern Sweden who were registered at SRAT (n= 313) were asked to participate in the study. The questionnaire was sent out electronically, which gave a response rate of 48% (n= 151). The response rate in the public dental health sevice was 59% (n= 101) and in private practice 35% (n=50). The survey questions covered work, work atmosphere, work situation, profession, health, influence and collegial support together with background questions about age, gender, employment status and working hours. The result showed a statistically significant difference (p<0.05) between the dental hygienists in the public dental health service and dental hygienists in private practice as regards to what extent the dental hygienists decided over their own scheduled time, experienced tiredness, worry, disorders from the back, neck or shoulders and disorders from other parts of the body. A statistically significant difference (p<0.01) between the dental hygienists in the public dental health service and the dental hygienists in private practice was also shown as regards to what extent the dental hygienists could control their own work pace. The conclusion from the limited material of this study is that the dental hygienists in private practice seemed to have a more positive view of their work situation compared to the dental hygienists in the public dental health service.</p>

Syftet med studien var att jämföra den upplevda arbetssituationen hos tandhygienister inom folktandvården med tandhygienister inom den privata tandvården. Tandhygienister i södra Sverige som var registrerade hos SRAT (n=313) tillfrågades att delta i studien. Enkäten skickades ut elektroniskt, vilket gav en svarsfrekvens på 48% (n=151). Inom folktandvården svarade 59% (n=101) och inom den privata tandvården svarade 35% (n=50). Enkätfrågorna omfattade arbete, arbetsklimat, arbetssituation, profession, hälsa, inflytande och stöd i yrkesrollen samt bakgrundsfrågor om ålder, kön, anställningsform och arbetstid. Resultaten visade statistiskt signifikanta skillnader (p&lt;0,05) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården gällande i vilken utsträckning de styrde över sina tidsbokningar, upplevde trötthet, orolighet, besvär från rygg, nacke eller axlar samt besvär från andra delar av kroppen. En statistisk signifikant skillnad (p&lt;0,01) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården syntes även i vilken utsträckning respondenterna styrde över sin arbetstakt. Slutsatsen av studiens begränsade material är att tandhygienisterna inom den privata tandvården tycktes ha en mer positiv syn på deras arbetssituation än tandhygienisterna inom folktandvården. / The aim of this study was to compare the perceived work situation among dental hygienists in the public dental health service with dental hygienists in private practice. Dental hygienists in southern Sweden who were registered at SRAT (n= 313) were asked to participate in the study. The questionnaire was sent out electronically, which gave a response rate of 48% (n= 151). The response rate in the public dental health sevice was 59% (n= 101) and in private practice 35% (n=50). The survey questions covered work, work atmosphere, work situation, profession, health, influence and collegial support together with background questions about age, gender, employment status and working hours. The result showed a statistically significant difference (p&lt;0.05) between the dental hygienists in the public dental health service and dental hygienists in private practice as regards to what extent the dental hygienists decided over their own scheduled time, experienced tiredness, worry, disorders from the back, neck or shoulders and disorders from other parts of the body. A statistically significant difference (p&lt;0.01) between the dental hygienists in the public dental health service and the dental hygienists in private practice was also shown as regards to what extent the dental hygienists could control their own work pace. The conclusion from the limited material of this study is that the dental hygienists in private practice seemed to have a more positive view of their work situation compared to the dental hygienists in the public dental health service.

Tandhygienistyrket är ett relativt nytt yrke. I Sverige har yrket funnits i cirka 40 år och har under denna tid genomgått stora förändringar. Tandhygienister behandlade från början enbart patienter som remitterades av tandläkare. Dessa faktorer kan ha bidragit till att personer som besöker tandvården idag inte alltid känner till vad en tandhygienist gör. Syftet med studien var att undersöka om personer som besöker en folktandvårdsklinik vet vad en tandhygienist gör. En studie med empirisk och kvantitativ design genomfördes med användning av enkäter, bestående av 22 frågor med fasta svarsalternativ. Sammanlagt besvarades 150 väntrumsenkäter av personer som besökte tre folktandvårdskliniker i Landstinget Blekinge. Urvalet var konsekutivt, författarna till studien tillfrågade personligen personer, 16 år och uppåt, i den ordning de anlände till väntrummen om de ville delta i studien. Merparten av respondenterna kände till att en tandhygienist självständigt genomför undersökningar, informerar samt arbetar förebyggande. Respondenterna var tveksamt inställda till om tandhygienister fick ställa diagnos på och behandla tandlossningssjukdom. Slutsatsen av studien är att en majoritet av de människor som besöker en Folktandvårdsklinik inte till fullo vet vad en tandhygienist gör. / Dental hygienist is a relatively new profession and the profession has existed in Sweden for about 40 years. During this time it has gone through major changes. In the beginning, dental hygienists only treated people who were referred by a dentist. These factors may have resulted in that visitors to public dental clinics not always knowing what a dental hygienist does. The aim of this study was to investigate if people who visited public dental clinics know what a dental hygienist does. An empirical study was carried out using a questionnaire containing 22 multiple-choice questions. In total 150 questionnaires were answered by visitors to three public dental clinics within Blekinge county. The sample method used was consecutive. The authors asked people 16 years and older, in the order in which they arrived at the clinic, if they would participate in the study. The majority of the participants were aware that dental hygienists carry out examinations independently, inform and work preventively. The participants were unclear that dental hygienists could diagnose and treat periodontal disease. The conclusion of the study is that visitors to public dental clinics do not know entirely what a dental hygienist does.

No description available.

Syftet med denna uppsats är att redogöra för varför tandhygienistyrket väljs och varför den två- eller treåriga utbildningen till tandhygienist söks?Uppsatsen ger en översikt hur tankegångarna tidigare har varit inför tandhygienist-utbildningens längd. Hösten 2010 ska den behörighetsutredning som regeringen tillsatt redovisa vad de kommit fram till om tandhygienistutbildningens längd. För att få svar på uppsatsens syfte har en enkät utlämnats till förstaårsstudenter på tandhygienistutbildningen i Kristianstad och Malmö. Resultaten från enkätundersökningen visar att endast hälften av tandhygieniststudenterna har utbildningen som sitt förstahandsval. Tandhygienistyrket väljs främst för att studenterna vill arbeta med människor men även för att de vill arbeta praktiskt och för att yrket har goda framtidsutsikter.Hälften av Malmöstudenterna valde Malmö just för att utbildningen där är tvåårig medan en tredjedel av Kristianstadstudenterna valde utbildningen för att den var treårig och de på så vis skulle få en bättre utbildning. / The purpose of this essay is to explain why the dental hygiene profession is chosen by dental hygiene students and why the two- or three-year program in dental hygiene is chosen. This essay provides an overview of previous ideas regarding the length of the dental hygiene education. A survey was made on first-year dental hygiene students at two universities in southern Sweden to find the answers to the purpose of this essay.The results from the survey shows that only half of the dental hygienist students put their education as the top choice when applying to university. The dental hygiene profession is chosen primarily because of the desire to work with people but also because they want to work with their hands and that the profession has good prospects.Half of the Malmo students chose Malmo just because the education is two years there while a third of the Kristianstad students chose the education there because it was three years and that they would have a better education therefore.

The purpose of this study was to determine the awareness and attitudes of dental hygienists in Ohio regarding the Advanced Dental Hygiene Practitioner (ADHP) as an occupation proposed by the American Dental Hygienists’ Association and to determine whether the ADHP could be a viable career option for Ohio dental hygienists. I developed a survey to assess dental hygienists’ awareness, attitudes, and their views regarding the new mid-level dental provider. The study was limited to licensed dental hygienists in Ohio. The study included a simple random sample of 400 of the 4100 dental hygienists in Ohio obtained by a systematic approach, a random start and selection of subjects at a constant interval. The method of data collection was electronic surveys. Fifty-four dental hygienists (13% of the sample) participated in the study. The results show that most of those responding were aware of the ADHP. Also, their attitude regarding the new mid-level dental provider was positive. Attitudes varied more when the respondents provided data on the adoption of legislation for the new provider. There was no consensus among respondents regarding the ADHP as a viable career option. More robust research is needed on the viability of the ADHP in Ohio.